TOTBİD Dergisi

TOTBİD Dergisi

2023, Cilt 22, Sayı, 2     (Sayfalar: 108-118)

Arthroscopic approach to chondral lesions: Chondral debridement, abrasion arthroplasty, microfracture, nanofracture

Turhan Özler 1, Burak Çağrı Aksu 1

1 Yeditepe Üniversitesi Tıp Fakültesi Hastanesi, Ortopedi ve Travmatoloji Ana Bilim Dalı, İstanbul

DOI: 10.5578/totbid.dergisi.2023.17
Görüntüleme: 320
İndirme : 314

Methods to stimulate the autoregeneration of joint cartilage in advanced chondral injuries have been used for many years and have changed over time in the light of new surgical equipment, techniques and studies. Today, it is frequently applied by almost every orthopedic surgeon side and is often seen as the first surgical treatment option. Basically, the expectation is to stimulate the subchondral and medullary bone marrow under the damaged hyaline cartilage in the defective area and to provide the formation of new cartilage with the closest possible strength to the hyaline cartilage as a result of the biological response of the organism. Although a wide variety of techniques have been described over time, mechanical chondral debridement, abrasion arthroplasty, microfracture and nanofracture are the most commonly used methods. In all other methods except mechanical chondral debridement, subchondral bone is penetrated with appropriate equipment to ensure migration and differentiation of cells in the bone medulla to the chondral area. In chondral debridement performed without penetration, the target is the regeneration of new cartilage extending from the surrounding edge tissue with healthy cartilage to the damaged area. However, although this method has beneficial results in the short term in patients, it is reported that it is not meaningful in the long term. In addition to surgical field factors in the stimulation of biological chondral regeneration, many variables such as general health status, age, presence of chronic disease affect the outcome, so success rates vary in the studies conducted.

Anahtar Kelimeler : chondral debridement; abrasion arthroplasty; microfracture; nanofracture